NCCN Guidelines for Patients® | Pancreatic Cancer - page 39

NCCN Guidelines for Patients
Pancreatic Cancer, Version 1.2014
Supportive care
Blocked stomach | Pain | Malnutrition or trouble eating
Blocked stomach
A tumor in the pancreas may also grow large
enough to block eaten food from passing out of your
stomach through the first part of the small intestine
(duodenum). This blockage can cause pain, vomiting,
and other problems. Treatments for a blocked
stomach include a stent, a PEG (
astrostomy) tube, or a duodenal bypass.
A stent is an expandable tube that is placed in the
duodenum to unblock it and keep it open. A PEG tube
is a tube that is inserted through a cut in the abdomen
and placed in the stomach to give food. A duodenal
bypass is a surgery to re-route the path eaten food
takes from the stomach into the small intestine. The
result is that the path out of the stomach avoids
(bypasses) the blocked part of the duodenum. This
surgery may also be done as a preventive measure
if there is a high risk that your stomach may become
You may have pain caused by the cancer. Pain can
occur when the tumor grows into nearby nerves or
presses against other organs. Pain is often treated
with drugs that are in pill form. Another treatment
is to inject alcohol (ethanol) into nerves around the
pancreas to destroy them. This treatment is called
a nerve block. Destroying the nerves reduces pain.
For certain patients with severe pain who haven’t had
radiation therapy as part of cancer treatment, there is
a third option. In this case, your doctor may consider
radiation therapy with or without chemotherapy to
help relieve the pain by shrinking the tumor.
Malnutrition or trouble eating
Healthy eating is always important. It includes eating
a balanced diet, eating the right amount, and drinking
enough fluids. Pancreatic cancer or its treatment
may make healthy eating a challenge by causing you
to feel not hungry, have abdominal cramps, or have
trouble digesting food. A nutritionist—an expert in
nutrition and food—can help.
You may also need drugs for diabetes—a disease
that causes high levels of sugar in the blood. Or, you
may need digestive enzymes because your pancreas
has been removed or isn’t working well because of
the tumor. Digestive enzymes are proteins that help to
break down (digest) eaten food for the body.
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